(Winnipeg, MB) A study of more than 1,000 Canadian mothers and infants has shown that exclusive
breastfeeding in the first three months of life provides more protection against an infant becoming overweight at one year of age than either partial breastfeeding or formula feeding.

The research, published today in JAMA Pediatrics, found a 63 per cent increased risk of becoming overweight among infants who were partially versus exclusively breastfed at threemonths of age, and a 102 per cent increased risk among exclusively formula-fed infants.

According to the researchers, this association is partially explained by the influence breastfeeding has on an infant’s gut microbiome—the community of microorganisms or bacteria that live in the human digestive tract.

“Breastfeeding is one of the most influential factors in shaping the infant gut microbiome,” says co-author Dr. Meghan Azad, Canada Research Chair in Developmental Origins of Chronic Disease at the University of Manitoba, and research scientist at the Children’s Hospital Research Institute of Manitoba (CHRIM).

“Our research showed that partial breastfeeding and exclusive formula feeding were associated with a higher microbial diversity at three months of age, meaning more types of microbes were present in the baby’s gut, as well as an abundance of a group of bacteria called Lachnospiracae, which has been associated with infant overweight,” explains co-author Dr. Anita Kozyrskyj, a professor in the Department of Pediatrics at the University of Alberta.

The study included 1,087 infants and their mothers who are participating in AllerGen’s CHILD Study—a national birth cohort study collecting a wide range of health, lifestyle and environmental exposure information from nearly 3,500 families and children from pregnancy to school age.

Families enrolled in the CHILD Study provided information about their babies’ breastfeeding status and diet at three, six and 12 months of age. DNA sequencing techniques performed in the laboratories of co-author Dr. James Scott, a professor of Occupational & Environmental Health at the Dalla Lana School of Public Health, and Dr. David Guttman at the University of Toronto provided information on the types and quantity of bacteria present in the infants’ digestive tracts.

“This is one of the largest infant microbiome studies in the world, identifying over 900 types of bacteria from 2.6 million DNA sequences generated from more than 1,000 infants,” says Scott, who is co-Director of the Synergy in Microbiota Research (SyMBIOTA) research platform with Kozyrskyj.

“Our research is unique in that we also distinguished between partial breastfeeding mixed with formula versus partial breastfeeding mixed with foods,” adds co-author Dr. Jessica Forbes, a postdoctoral researcher at the University of Manitoba.

“We found that breastfed infants supplemented with formula were at increased risk for becoming overweight at one year of age, and had a different microbiota composition than exclusively breastfed infants; whereas breastfed infants supplemented with complementary foods only (no formula) were similar to exclusively breastfed infants with no increased risk.”

The study is also the first to evaluate the potential association of a brief use of infant formula (during the hospital stay only) with the infant microbiota and the risk of becoming overweight. The findings revealed subtle yet significant microbiota differences at three to four months of age after use of formula only during the hospital stay after birth. However, these differences were not associated with overweight at one year of age, and the clinical implications of these changes need to be studied further, according to the researchers.

“Together, these results emphasize the importance of breastfeeding as a possible protective factor against infant overweight by modifying the gut microbiome,” adds Dr. Azad. “They suggest that improved programs and policies to support exclusive breastfeeding could have a meaningful impact on infant health.”

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Kamal M, Tamana SK, Smithson L, Ding L, Lau A, Chikuma J, et al. Phenotypes of sleep-disordered breathing symptoms to two years of age based on age of onset and duration of symptoms. Sleep Medicine. 48:93–100.

Citation

Forbes JD, Azad MB, Vehling L, Tun HM, Konya TB, Guttman DS, et al. Association of Exposure to Formula in the Hospital and Subsequent Infant Feeding Practices With Gut Microbiota and Risk of Overweight in the First Year of Life. JAMA Pediatr. Published online June 4, 2018. doi:10.1001/jamapediatrics.2018.116

Information must be provided on funding mechanisms for sample analyses and the study completion

Evidence must be provided that ethics approval is available

Rationale must be provided as to why the requested samples are required at the current time, rather than after completion of the Study’s 5-year follow-up, with the potential at that time for a more efficient study design; e.g., nested case-controls, etc.